Penile preservation for male urethral cancer

Tumors of the male urethra are rare, comprising<1% of urologic malignancies. This is a report of a 44-year-old man presented with a 4-month history of gross initial hematuria and dysuria. After examining the patient, we found a firm mass extending 1 cm within the proximal bulbar urethra and a pathologic report of moderately differentiated squamous cell carcinoma. He underwent excision of the involved urethra followed by end-to-end bulbar urethroplasty. External beam radiation was performed at the dose of 6000 Rad, in 33 courses. The patient was followed by surveillance protocol and, no evidence of urethral or bladder tumor was found in the 2-year follow-up with bi-annual cystoscopic examination

Review of ten-yrs leprosy cases in Azerbaijan, northwest of Iran

Leprosy is a rare but important infectious disease caused by mycobacterium leprae. Word health organization suggested a strategy to reduce the prevalence of the disease to less than one per 10000 people. It seems that the leprosy is now in its elimination stage because during a period of ten years only few new cases were found in Iran. We studied 157 new leprosy cases that were referred to and registered in Bababaghi Center, Azerbaijan, Northwest of Iran. A total of 157 new cases, 107 [68%] males and 50 [32%] females were born in Azerbaijan with the peak age of the disease at their fourth decade. The most common form of the disease, especially in male patients, was lepromatous leprosy. Skin problems, especially eyebrow hair loss, constituted the most frequent sign of the disease. The most involved nerve was ulnar nerve. Leprosy is a chronic infectious disease that is associated with serious morbidity if left untreated. Although, leprosy is a rare disease in Iran it is important for the physicians to be aware when they visit a patient with chronic dermatitis with peripheral nerve involvement

Molecular detection of prostate specific antigen in patients with prostate cancer or benign prostae hyperplasia the first investigation from Iran

Prostate cancer is the second common form of cancer in men. Detection of circulating Prostate Specific Antigen [PSA] transcripts has effectively been used for early diagnosis of prostate cancer cells. This investigation employed a reverse transcriptase polymerase chain reaction [RT-PCR] technique to distinguish the patients with either localized or metastatic prostate cancer [CaP] vs. Benign Prostate Hyperplasia [BPH] and control subjects, as compared with clinical and pathological records. With reservation of ethical issues, blood samples were collected from 60 cases. Based on pathological and clinical findings, 25 patients [20 with localized cancer, 5 with metastatic], 22 with BPH, and 13 healthy [including 3 females] subjects as negative controls, were selected from Shariati, Mehrad, Sina,, Khatam and Atie Hospitals in Tehran, Iran. RT-PCR for a 260 bp PSA transcript was then performed. Clinical and pathological records were used for the assessment and comparison of PSA RT-PCR results. None of the control subjects and BPH [with 7 exceptions] were found positive by RT-PCR [Relative specificity= 72.7%]. In patients with prostate cancer, 21 out of 25 were found PSA positive [Relative sensitivity=83.4%] and the remaining 3 have been shown to be PSA negative [Positive predictive value= 83.4%]. All of 5 metastatic patients [100%] revealed PSA positive results. Our data reflects the clinical relevance and significance of RT-PCR results as assessed with clinical and pathological examinations. PSA RT-PCR might be used as a powerful means for diagnosis, even when either pathological or clinical findings are negative, and could be employed for further molecular epidemiology surveys

Prostate cancer screening, yes or no? The current controversy

The increasing incidence of prostate cancer and different viewpoints of medical authorities to it, has lead to conversion of preliminary plan of screening test to a requisite. The objective of this study is to clarify the obscure aspects of this subject using the literature review. We reviewed the following items in the literature: prostate cancer screening, introduction of relevant tests, screening criteria according to World Health Organization, screening experience in different countries, community notification, specialists training in order to establish an integrated approach and treatment, anxiety relief, and promotion of patient awareness in this field. It has been shown that, except in China, programmed and official screening of prostatic cancer has not been accepted by concordant responsible authorities, neither in developed countries nor in developing ones. However, it is performed informally in different parts of the world. There is no unanimous consensus about performance of screening for prostate cancer. Continuing voluntary referral of men above 50 years old for performing prostatic specific antigen [PSA] test has been accepted universally and is being done potentially, defined as "opportunistic screening"

Correlation between prostate needle biopsy and radical prostatectomy gleason gradings of 111 cases with prostatic adenocarcinoma

There are conflicting reports in the literature about correlation of biopsy and prostatectomy Gleason scores in prostate carcinoma. The goal of this study was to determine the correlation of grading in these two types of pathologic materials. The coupled Hematoxylin and Eosin slides of 111 patients with prostate carcinoma were collected. Gleason scores were determined. Patients who had undergone any therapy except surgery were excluded from the study. Correlation between grades was calculated by determination of correlation coefficient. Accuracy of biopsy grading in prediction of final grade was also determined by measuring the sensitivity, specificity, and positive and negative predictive values. In 50 cases [45%], grade was underestimated in the biopsy. After dividing the cases into Gleason scores of 2 to 4, 5 to 6, 7, and 8 to 10, the most of undergraded cases [84.2%] were in the first group [Gleason score 2 to 4] and this rate reached 5% in the fourth group [Gleason score 8 to 10]. The correlation coefficient measured was 0.535 in grade to grade comparing and 0.514 in group to group comparison of the specimens. In low-grade tumors, grading in biopsy, in spite of high sensitivity [90.9%], had low positive predictive value [26.3%]. There is a moderate direct linear relationship between scores in biopsy and prostatectomy specimens. But there is a high probability of underestimation of real Gleason score of the radical prostatectomy specimen in low-grade tumors. Pathologists and urologists must consider the phenomenon of undergrading in reporting prostate specimens and managing patients

Effect of sublingual nitroglycerine on pain relief in renal and ureteral colic

The effect of sublingual nitroglycerine [TNG] on relieving pain in renal and ureteral colic was studied in a randomized, prospective, double blind and placebo controlled clinical trial. One hundred out-patients between 16-60 years of age from either sex who were admitted to the urology emergency center of Ayatollah Taleghani and Ashrafi Esfahani hospitals were chosen for this study. They were divided into two groups; fifty-one of them were treated with TNG [0.4 mg initially and two similar doses if necessary at 5 minute intervals] and the remaining received placebo. The scoring of pain was performed using Lee et al's method. Chi-square test was used for statistical analysis of data. Although the severity of pain was reduced one degree by TNG [p<0.07] in comparison with placebo, TNG was not effective in the treatment of colic pain [p<0.05]

Anterior urethral valve associated with posterior urethral valve

A rare case of anterior urethral valve in association with posterior urethral valuve is reported. Clinical findings are discussed, and the available literature will be briefly reviewed